Health Care

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Higher ed needs to destigmatize suicide (essay)

I was saddened last week to read about the suicide of Professor Will Moore at Arizona State University. Everyone’s path is different, but mine led me to attempt suicide last semester. Like Moore, I wrote a series of notes on social media and then did not expect to wake up. Waking up from a suicide attempt, the first thing I learned was that there is a latent social stigma around it that, in fact, protects suicide and helps it survive.

It struck me that Moore’s last note called out this “taboo” around suicide. He’s right. It is not to be talked about, especially in print. I experienced this in the first draft of this article, which was rejected by another publication that responded, “We receive dozens of manuscripts each week on all sorts of topics and have to make some tough choices.” Tough choices. Yes. Well, talking about suicide can even be difficult in therapy. I remember my therapist referring to it as “the overdose” with a bit of Southern charm -- suggesting that the issue wasn’t mental health, the norms of academe or a social system that has failed me but rather an unfortunate accident. My overdose was not an accident. And it had no charm.

I was teaching last semester, and halfway through I took pills. Specifically, a lot of pills. I took them on the weekend and woke up unexpectedly a day or so later. At some point early on, in the haze of consciousness and aliveness, I realized that I needed to prepare my lectures for the week. And so I did. I tried to kill myself on Saturday night, woke up on Sunday night and taught on Tuesday and Wednesday. In academe, that is part of the dysfunctional routine we normalize. We research and we teach, even when we have tried very hard to kill ourselves two days before. I think this is, dare I say, a fatal flaw in academe. So I wanted to note three things I have learned.

First, people might not understand the side effects from surviving trying to kill yourself. They are really terrible. If you go to the hospital, you might have a different experience because it is possible to pump your stomach, but I did not go to the hospital. I was worried about losing my job at the university if I did. What if they committed me? Who would teach my courses that week? Would this get out and be a mark against me in looking for future jobs?

So I stayed home and drank water. The results were physically devastating. I had difficulty walking and seeing for two weeks. I now have asthma and high blood pressure. Somehow I taught -- the way we all do when our friends tell us, “Whatever you do, don’t go in to work.” I stayed out of my colleagues’ way that week, got through my classes and went home to bed.

Second, there is no easy way to talk about mental-health events in the workplace. This truth was also echoed in the recent piece on Moore. How do you have a conversation that you have been systematically trained not to have? In our academic departments, we celebrate the arrival of new babies, we commemorate deaths, we bring cake for birthdays and we go out for drinks for promotions. We celebrate the positive but avoid confronting the often sad reality. Where does attempted suicide fit into this? Maybe it isn’t something to share. Maybe it is “too much information,” like domestic violence. Maybe this is another sad thing that is something to be silenced, hidden away -- assuming that next time, next time, it’ll be “successful.” That’s a much easier goal to have: death. It works for those who are suicidal and those who don’t want to have the conversation. Yet this uncomfortable situation betrays a truth that, in academe, this is a conversation literally dying to be had.

And, last, our students get it, yet we perpetuate a double standard. Our students experience mental-health issues, and we encourage them to talk and seek help. Our students attempt suicide and we give them support in class. It would never sink their future careers. When it is us, however, we shut down.

So we (the academy) should ask why we are tiptoeing around an issue that is part of the lived experience of our faculty and that, if unacknowledged, could lead to death. As many of us can attest, good mental health for all staff and faculty members is not a reality in most departments. I have written this piece using a pseudonym. As the Inside Higher Ed article on Moore noted, where you are in your career dramatically influences what you feel safe talking about. I am in the early part of my career, so I’m terrified of losing my employability.

Indeed, the real task falls to colleges and universities to step up on behalf of adjuncts, untenured professors and all other faculty and staff members. They should consider 2017 as an opportunity to engage not simply in suicide prevention but also suicide destigmatization. This is an affirmative step that should not wait for the death of another Moore or situations like mine. Because you cannot ask people who are suicidal to solve this problem -- that’s the whole point, we need help, and here we are, asking for it.

So I would leave you with this: very good people can have very bad days, and those people should not do what I did. They should go to the hospital, feel free to tell their colleagues and speak up about it before it is too late. Stigma is something we all reproduce or disrupt. Universities can be leaders here. Today.

The National Suicide Prevention Lifeline is a free, confidential 24-7 service that can provide people in suicidal crisis or emotional distress, or those around them, with support, information and local resources. 1-800-273-TALK (8255).

The author works at a large public research university.

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Essay warns against too much of a shift away from science in training future doctors

An organic chemist I know tells her doctors that she is a professor of Southern literature whenever she is in the hospital. That’s because organic chemistry has come to symbolize all the irrelevant science hoops that premedical and medical students jump through on the way to becoming physicians. Today, we are told, medical students should be learning “people skills,” placing medicine in the context of the community and learning how individuals make choices related to their health. These preferences are reflected in the revised medical admissions test rolled out earlier this year, with its newly added questions related to sociology, psychology and the humanities. This summer, as interviews begin at medical schools around the country, candidates who want to make the final cut are sometimes playing down their science credentials in favor of their relational skills.

This seems to me to be a false dichotomy. To be sure, I want my physician to understand how to deal with me as an individual and as a member of my social group. But I also want her to appreciate the underlying molecular nature of disease and to know how to evaluate scientific and statistical evidence about clinical trials and treatments.

The movement away from science springs from a misunderstanding that is not limited to the premed curriculum. Many people have the experience of science taught as a series of isolated facts to be memorized. All physicians recall memorizing biochemical pathways for which they have no use past the final exam in a given course. If there were ever a time when memorization had a place, that time is gone. Facts are cheap and readily available on every smartphone and computer.

The truth is that science is about so much more than memorizing a set of facts. Practitioners with a solid scientific grounding are able to analyze data and put that data in context, rely on what is known from previous studies and extrapolate to the future, and understand how changing environmental conditions are reflected in bodily conditions.

I have taught biochemistry to medical and undergraduate students for over 30 years. Premedical students usually come into my classes expecting to memorize structures, nomenclature, and pathways and are a bit taken aback at the idea that there is anything to learn other than that. By examining experimental data and case studies they become familiar with the core of biochemistry and are able to go far beyond rote learning. Unfortunately I hear back from them once they are in professional schools that, “it was great that you taught us about concepts, but you should have had us memorize more since that is what we have to do here.” As long as the health professions emphasize the acquisition of facts rather than their application, science will be seen as dry, uncreative and mostly irrelevant to the “real” world.

Along with colleagues at Wellesley -- Lee Cuba and Alexandra Day -- I recently published a study of science majors at liberal arts colleges. Our major finding was that science majors who took many courses outside of the sciences were better able to make connections among disciplines. Some medical schools -- Mount Sinai in New York is a prominent example -- have begun recruiting humanities majors to their classes, requiring fewer science courses than for the typical applicant because they are thought to bring different strengths to the profession. This move is well intended, but it misses the point.

Privileging humanities majors in medical school admissions may inadvertently reinforce the opposition between the “soft skills” associated with humanists and the technical capabilities associated with scientists. Long before the health sciences became deeply specialized, renowned physicians such as Hippocrates, Maimonides, John Locke and John Keats were as much philosophers and poets as scientists. Although that kind of Renaissance career may no longer be practical, today a strong liberal arts education in both the arts and sciences provides the most effective preparation for the medical profession.

Medical schools would do better to recruit broadly educated science students who bring the complementary strengths of integration among disciplines and a deep grounding in the process of scientific discovery and analysis to their study and practice of medicine. If we want knowledgeable and competent doctors who are also well-rounded and compassionate individuals, we must stop treating the arts and sciences as mutually exclusive. We must help our students see the connections between what they are learning in the classroom and what they will practice in the “real world,” to see that organic chemistry and Southern literature are not irreparably separate, but that each may have a role in a medical education.

Adele Wolfson is Nan Walsh Schow and Howard B. Schow Professor of Physical and Natural Sciences and interim dean of students at Wellesley College.

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